Provider Demographics
NPI:1629616156
Name:RUTLEDGE, CARILYNN WRIGHT (MSN, CNM)
Entity Type:Individual
Prefix:MRS
First Name:CARILYNN
Middle Name:WRIGHT
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41680 MISS BESSIE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-2963
Mailing Address - Country:US
Mailing Address - Phone:301-997-1788
Mailing Address - Fax:
Practice Address - Street 1:41680 MISS BESSIE DR STE 102
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-2963
Practice Address - Country:US
Practice Address - Phone:301-997-1788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR130638367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife